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Venting subcutaneous emphysema
Ronald Simon trauma-list@trauma.orgTue, 08 Jan 2002 19:05:22 -0500
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I have a case i'd like your opinion on. Sorry for the multi listing but this problem crosses specialties. A 48 yo woman victim of MVC. Has multiple rib fx, pulm contusions, R pneumothorax for which a chest tube was placed. Patient now several days out chest tube still has small airleak, lung is up on chest xray. She has over the last few days developed significant subcut emphysema of her chest and face. My collegue wants to place a mediastinal "vent" (small incision above the manubrium to allow the air to escape). This does not make sense to me but in trying to be open minded i'm wondering if this is a described treatment. As far as i'm concerned as long as the chest tube is controlling the leak, the SQ air is unsightly and has no adverse effects unlike making a connection between the mediastinum and the outside world. Thanks for your input Ron Simon, MD Jacobi Medical Center Bronx, NY
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